HESI RN
HESI RN Exit Exam Capstone
1. A client is admitted with ascites, malnutrition, and recent complaints of spitting up blood. What assessment finding warrants immediate intervention by the nurse?
- A. Capillary refill of 8 seconds
- B. Bruises on arms and legs
- C. Round and tight abdomen
- D. Pitting edema in lower legs
Correct answer: C
Rationale: A round and tight abdomen suggests fluid accumulation from ascites, which could signal a more severe underlying condition requiring immediate intervention. This finding indicates increased intra-abdominal pressure, which can lead to respiratory compromise or other serious complications. Capillary refill time, bruises on arms and legs, and pitting edema in the lower legs are important assessments but do not directly indicate the need for immediate intervention as a round and tight abdomen does in this case.
2. What is the most common symptom of gastroesophageal reflux disease (GERD)?
- A. Heartburn.
- B. Nausea.
- C. Abdominal pain.
- D. Vomiting.
Correct answer: A
Rationale: The correct answer is A: Heartburn. Heartburn is the most common symptom of GERD as it occurs due to the reflux of stomach acid into the esophagus. This leads to a burning sensation in the chest that can worsen after eating, lying down, or bending over. Choice B, Nausea, is not typically the most common symptom of GERD, although it can occur in some cases. Choice C, Abdominal pain, is not a primary symptom of GERD and is more commonly associated with other gastrointestinal conditions. Choice D, Vomiting, is also not the most common symptom of GERD, although it can occur in severe cases or as a result of complications.
3. Legislation allowing nursing staff to provide contraceptives has resulted in all of the following EXCEPT:
- A. More nursing staff have been trained to provide family planning services
- B. Many population and family planning organizations have emerged
- C. Enhanced implementation of population and family planning programs
- D. Male involvement in family planning services
Correct answer: D
Rationale: The correct answer is D. Male involvement in family planning services has not significantly resulted from legislation allowing nursing staff to provide contraceptives. While legislation has led to more nursing staff being trained, the emergence of population and family planning organizations, and enhanced implementation of programs, it has not directly impacted male involvement in family planning.
4. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct answer: C
Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.
5. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?
- A. Decreased heart rate
- B. Increased weight
- C. Increased energy levels
- D. Decreased appetite
Correct answer: C
Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.